scholarly journals Labour ward incidents and potential claims – lessons learned from research

Clinical Risk ◽  
2008 ◽  
Vol 14 (6) ◽  
pp. 235-238 ◽  
Author(s):  
Brenda Ashcroft
Keyword(s):  
Human Error ◽  
Night Shift ◽  
Birth Asphyxia ◽  
Shoulder Dystocia ◽  
Lessons Learned ◽  
High Rate ◽  
Critical Periods ◽  
Term Infants ◽  
North West ◽  
The North

This paper provides an insight into the underlying factors involved in potential cerebral palsy and/or shoulder dystocia claims. The research was undertaken to identify the root causes of 37 cases of birth asphyxia in term infants severe enough to warrant admission to neonatal care units in the north-west of England between 2001 and 2002. All available staff ( n = 93) providing care during critical periods were interviewed by the author using the cognitive interviewing technique. These included 81 midwives, two consultant obstetricians, eight registrars and two senior house officers. An expert panel consisting of consultant obstetricians, midwives, a consultant neonatologist and the researcher applied the Bolam test to identify instances where care had been substandard and injury caused as a result. Although the cases were often complex, covering more than one shift and over more than one stage of labour, the most dangerous time appeared to be during the night shift (19 cases, 51%), followed by the evening shift (13 cases, 35%) and then the day shift (five cases, 14%). The main problems include: failure to respond appropriately to signs of fetal hypoxia (26 cases, 70%); undiagnosed obstruction (22 cases, 59%), which was broken down into failure to identify cephalopelvic disproportion (13 cases, 35%); and shoulder dystocia (nine cases, 24%). Delayed resuscitation of the infant occurred in 26 cases (80%), and in 18 cases (49%) there was excessive and inappropriate use of Syntocinon. All cases involved human error, either through a delay or failure to take action, or taking inappropriate action. However, these were all underpinned and perpetuated by system and cultural errors present in the labour wards, such as allowing unsupported and inexperienced personnel to work in a position for which they lacked the necessary skill and experience. This was perpetuated by the customary practice of using unsupervised junior medical staff in a first on-call position for complications, and also of failing to sustain safe midwifery staffing levels. This in turn prevented support for more inexperienced staff. Consequently, when inexperienced midwives and obstetricians were left unsupervised in charge of complicated cases, it created accidents waiting to happen. When unsupervised and inexperienced paediatricians attended the birth of an asphyxiated infant, the child's condition deteriorated further when they were unable to resuscitate it. If such system and cultural errors as these are not rectified, the current high rate of damaged babies is likely to continue.

Modeling of social management organization in three communes with special difficulties in three poor districts (Program 30A) in the North West, Central Highlands and the South West - Results and lessons learned

2018 ◽  
Author(s):  
Vu Thi Thanh Minh
Keyword(s):  
Rural Communities ◽  
Positive Impact ◽  
Lessons Learned ◽  
North West ◽  
The North ◽  
Intensive Farming ◽  
West Central ◽  
Central Highlands ◽  
New Countryside ◽  
Social Management

Analysis of the specific results of the organizational model of social management, we found that the model of the project “Building a model of organization building community New Rural in 3 poor communes towels in 3 districts of poverty (Program 30A) of the three regions North West, Central Highlands and Southwest “ has made a very positive impact on the community, contributing very important in improving the internal resources of rural communities villages in new countryside construction. Through the activities of the awareness project of ethnic minorities are enhanced. They have learned to use scientific and technical advances in cultivation and intensive farming; maintaining clean, beautiful village. Conventions of villages hamlets have been revised and supplemented to meet the requirements of law and relevant customs and practices, local knowledge, ethnic psychological characteristics of rural communities villages; community spirit of each of the households increasingly advanced workers

Observed Seismic Behavior of Buildings in Northern Pakistan during the 2005 Kashmir Earthquake

2010 ◽  
Vol 26 (2) ◽  
pp. 425-449 ◽  
Author(s):  
Amjad Naseer ◽  
Akhtar Naeem Khan ◽  
Zakir Hussain ◽  
Qaisar Ali
Keyword(s):  
Seismic Behavior ◽  
Lessons Learned ◽  
Masonry Buildings ◽  
Kashmir Earthquake ◽  
North West ◽  
Clay Bricks ◽  
The North ◽  
Concrete Blocks ◽  
2005 Kashmir Earthquake ◽  
Recent Earthquakes

Recent earthquakes in Pakistan demonstrated that the region is highly seismic. Masonry buildings constructed with stones, concrete blocks, and fired-clay bricks and concrete buildings were damaged during the 8 October 2005 Kashmir earthquake. This paper presents the seismic behavior of reinforced concrete and masonry buildings in northern part of the North-West Frontier Province (NWFP) and Kashmir during the earthquake. Most of the buildings were observed to be nonengineered or semi-engineered. The paper presents an overview of the 1937 Quetta building code and the 1986 and 2007 building codes of Pakistan. Lessons learned during the earthquake are also presented.

scholarly journals  Prevalence of Linguatula serrata infection among dogs (definitive host) and domestic ruminants (intermediate host) in the North West of Iran

2011 ◽  
Vol 56 (No. 11) ◽  
pp. 561-567 ◽  
Author(s):  
F. Rezaei ◽  
M. Tavassoli ◽  
A. Mahmoudian
Keyword(s):  
Infection Rate ◽  
Age Groups ◽  
High Rate ◽  
Upper Respiratory Tract ◽  
Intermediate Hosts ◽  
Mesenteric Lymph Nodes ◽  
Linguatula Serrata ◽  
North West ◽  
The North ◽  
Domestic Ruminants

 Linguatula serrata is a zoonotic parasite causing visceral and nasopharyngeal linguatulosis in humans. Dog and other canines are the main definitive hosts while most herbivores, including ruminants serve as intermediate hosts for linguatulosis. Human rarely become infected as both final and intermediate hosts. This survey aimed to assess the L. serrata infection rate of dogs and domestic ruminants in North West of Iran. The upper respiratory tract of 97 dogs including 45 females and 52 males and the mesenteric lymph nodes (MLNs) of 396 goats (203 females and 193 males), 406 buffaloes (166 females and 240 males), 421 cattle (209 females and 212 males) and 438 sheep (223 females and 215 males) were examined for L. serrata. Animals were categorized into four age groups, including under six months, six to 24 months, two to four years and more than four years. Results showed that 27.83% of dogs were infected with L .serrata. The infection rate for goats, buffaloes, cattle and sheep was 50.75%, 26.6%, 36.62% and 42.69%, respectively. The prevalence rate in all animals was significantly associated with age and sex (P ≤ 0.05). In ruminants, the highest infection rate was found in goats (P ≤ 0.05). The results from this study indicate a high rate of infection in dogs and domestic ruminants, suggesting a potential high risk of zoonotic infection in man in the investigated area.  

Effects of grazing management on Sirosa phalaris herbage mass and persistence in a predominantly summer rainfall environment

2000 ◽  
Vol 40 (2) ◽  
pp. 155 ◽  
Author(s):  
G. M. Lodge ◽  
B. A. Orchard
Keyword(s):  
New South ◽  
Summer Rainfall ◽  
Grazing Management ◽  
Critical Periods ◽  
North West ◽  
The North ◽  
South Wales ◽  
Continuous Grazing ◽  
Plant Frequency ◽  
On Farm

Herbage mass, plant frequency and basal cover data collected from September 1993 to August 1996 were used to compare the effects of various seasonal closures with continuous grazing on the persistence of Sirosa phalaris (Phalaris aquatica cv. Sirosa) at 3 sites on the North West Slopes of New South Wales. Sites were on-farm and consisted of up to 10 treatments with 2 replicates and treatments were initially imposed in 2 different years. Pastures were either newly sown (3 years old) and grazed by either sheep or cattle, or degraded (14 years old) and grazed by sheep. Drought conditions prevailed in 1994–95, confounding the interpretation of the importance of treatments that involved long periods of closure, since significant effects could be attributed to both grazing exclusion and the timing of the closure in relation to plant phenology. However, across all sites and years, fitted values for phalaris herbage mass were generally significantly higher than the continuously grazed control in only 2 treatments: spring closure (at 1 site) and an extended spring closure combined with an autumn closure (at all sites). At the end of these studies phalaris herbage mass in spring–autumn closures was 4–32 times higher than the control plots. These results were confirmed by analysis of initial and final plant frequency data. At all sites, no recruitment of Sirosa seedlings occurred in any treatment. These data support the hypothesis that for increased persistence in a summer rainfall environment Sirosa phalaris requires some form of grazing management that involves the exclusion of grazing in the critical periods of spring and autumn.

Application of formation pressure while drilling in Australia: North West Shelf examples

2009 ◽  
Vol 49 (2) ◽  
pp. 568
Author(s):  
Dmitry Molohkov ◽  
Andy Pietsch ◽  
Jack Harfoushian ◽  
Shahid Azizul Haq
Keyword(s):  
Drill Pipe ◽  
Cost Effective ◽  
Lessons Learned ◽  
Formation Pressure ◽  
Well Control ◽  
North West ◽  
Service Companies ◽  
The North ◽  
Essential Input ◽  
Formation Pore Pressure

Since its introduction in the 1950s, the point-by-point wireline formation pressure measurement technique has been successfully used for formation evaluation and reservoir management, and has been an essential input into reservoir models. In exploration and appraisal wells, where depletion has not yet affected the reservoir, vertical pressure profiling can be used for fluid gradient determination that may be interpreted in terms of fluid densities and contacts. In a dynamic producing environment pressure measurements can help to identify vertical and horizontal boundaries and communication. Measurement of pressure distribution along the borehole was historically done with wireline instruments or, in difficult logging conditions, with wireline instruments conveyed by drill pipe. In some environments, especially in highly deviated and S-shaped wells or unconsolidated formations, drill pipe conveyance of wireline formation pressure testers introduces significant operational risk. Formation Pressure While Drilling (FPWD), introduced in 2003, offers a new cost-effective solution for gathering formation pressure data. FPWD is a new method to directly measure formation pore pressure as the well is being drilled, extending its application beyond traditional fluid typing, contacts and compartmentalisation determination to well control and drilling optimisation. The market for FPWD is developing rapidly with all major service companies providing their own implementations of the technology. The next step in the evolution of FPWD technology—sampling while drilling—is not commercially available yet, but this is just a matter of time. The case history presented in this extended abstract is an example of the application and lessons learned from the FPWD service used in one of the oil fields on the North West Shelf, Australia.

Factors that Contribute to the High Rate of Teenage Pregnancy and its Reduction in a High-Risk Area in North West, South Africa

2020 ◽  
Vol 22 (2) ◽  
Author(s):  
Leepile Alfred Sehularo ◽  
Kebitsamang Elizabeth Medupe ◽  
Omphemetse Meno
Keyword(s):  
South Africa ◽  
High Risk ◽  
Teenage Pregnancy ◽  
High Rate ◽  
Risk Area ◽  
High Risk Area ◽  
North West ◽  
Teenage Girls ◽  
Individual Interviews ◽  
The North

Teenage pregnancy is a global concern, and is associated with high levels of sociomedical morbidity. However, no studies have been conducted on this topic at a high-risk area in the North West province of South Africa. The aim of this study was to explore and describe the factors that contribute to the high rate of teenage pregnancy and its reduction in a high-risk area in North West. A qualitative, exploratory, descriptive and contextual research design was used to achieve the aim of the study. A non-probability purposive sampling method was used to select 15 teenage girls aged between 13 and 19 years. A total of 15 semi-structured individual interviews were used to collect data from the teenagers. Tech’s open-coding method of qualitative data analysis was used separately by the researcher and the co-coder to analyse the data. Two themes emerged, namely, contributory factors of teenage pregnancies and factors that could help to reduce teenage pregnancies. The findings of the study indicate that to effectively reduce teenage pregnancies in the high-risk area in North West, the teenagers, friends, parents, families, tavern owners and health professionals must adopt a collaborative approach to work together to fight this problem. Recommendations were made to reduce teenage pregnancies in the high-risk area in North West.

Spatial and temporal patterns of reptile roadkill in the north-west Australian tropics

2019 ◽  
Vol 25 (4) ◽  
pp. 370 ◽  
Author(s):  
Holly Hastings ◽  
James Barr ◽  
Philip W. Bateman
Keyword(s):  
Western Australia ◽  
High Rate ◽  
Survey Method ◽  
Road Mortality ◽  
Natural Ecosystems ◽  
Spatial And Temporal Patterns ◽  
Wet Season ◽  
North West ◽  
The North ◽  
Carcass Persistence

Roads present unavoidable challenges to wildlife, both in populated and in more remote regions. Both traffic infrastructure and road vehicles can have a detrimental impact on natural ecosystems and wildlife populations. This study aimed to gain a broad overview of the impacts of a stretch of road on native herpetofauna in north-western Australia. Reptile roadkill was surveyed along a 31-km stretch of the main road in Broome, Western Australia for eight months, during both the wet and dry seasons. There was a significantly higher rate of road mortality in the wet season despite a decrease in traffic intensity. Incidence of roadkill varied between reptile clades, with varanids being the mostly frequently recorded as roadkill. Carcass persistence experiments, however, highlighted a potential significant underestimation in roadkill due to an extremely high rate of carcass removal, emphasising the need to consider this variable when using roadkill as a survey method. We recommend that carcass persistence should be further investigated in order to accurately assess extent of reptile roadkill in the region, and how roads and traffic may impact at-risk species and populations.

SEM and TEM observations of sperm development in the testis of the freshwater fish Oreochromis mossambicus

1990 ◽  
Vol 48 (3) ◽  
pp. 58-59
Author(s):  
Daryl A. Cornish ◽  
George L. Smit
Keyword(s):  
Morphological Characteristics ◽  
Oreochromis Mossambicus ◽  
Breeding Cycle ◽  
Limited Information ◽  
North West ◽  
The North ◽  
Sem And Tem ◽  
Sperm Development ◽  
Ultrastructural Characteristics ◽  
The University

Oreochromis mossambicus is currently receiving much attention as a candidater species for aquaculture programs within Southern Africa. This has stimulated interest in its breeding cycle as well as the morphological characteristics of the gonads. Limited information is available on SEM and TEM observations of the male gonads. It is known that the testis of O. mossambicus is a paired, intra-abdominal structure of the lobular type, although further details of its characteristics are not known. Current investigations have shown that spermatids reach full maturity some two months after the female becomes gravid. Throughout the year, the testes contain spermatids at various stages of development although spermiogenesis appears to be maximal during November when spawning occurs. This paper describes the morphological and ultrastructural characteristics of the testes and spermatids.Specimens of this fish were collected at Syferkuil Dam, 8 km north- west of the University of the North over a twelve month period, sacrificed and the testes excised.

The North West Passage

2014 ◽  
Author(s):  
Roald Amundsen ◽  
Godfred Hansen
Keyword(s):  
North West ◽  
The North
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